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2. Election Specific Poll Worker Availability

   Currently asking for assistance with the April 4th 2023 Election.

4. First Name*
5. Last Name*
7. Phone Number*
8. Email*

   A reminder will be sent to this email before the election.

10. Shift Preference*

    1. All Day - 6:30am to 9:30pm-ish
    2. AM - 6:30am to 2:00pm - Morning
    3. PM - 1:45pm to 9:30pm-ish - Evening
    4. AM or PM - but not both

    Assignments will be planned prior to Election Day but may be changed on Election Day as the need arises. 

12. Your first location preference*

    1. Brookfield East HS - D1 - W1, 2, 3
    2. Burleigh Elementary - D2 - W4, 5, 6, 22
    3. Dixon Elementary - D3 - W7, 8, 9
    4. Sharon Lynne Wilson Center - D4 - W10, 11, 12
    5. Public Safety Building - D5 - W13, 14, 15
    6. Brookfield Conference Center - D6&D7 - W16 thru W21
    7. Any site is ok with me!

    Make your top ONE choice in this column. 

13. Your second location preference

    1. Brookfield East HS - D1 - W1, 2, 3
    2. Burleigh Elementary - D2 - W4, 5, 6, 22
    3. Dixon Elementary - D3 - W7, 8, 9
    4. Sharon Lynne Wilson Center - D4 - W10, 11,12
    5. Public Safety Building - D5 - W13, 14, 15
    6. Brookfield Conference Center - D6&D7 - W16 thru W21
    7. Any site is ok with me, after my first preference.

    Mark as many as you want in this column. 

15. On Call

    1. I would like to be "on call" for MY district only if someone is not available.
    2. I would like to be "on call" for ANY district only if someone is not available.

    If you cannot quite commit to the election, you can be added to the on-call list. If someone does not show or calls in sick, we would call you and ask you to come in. The on-call list is always used. 

17. Notes
    • Dress in layers.
    • Bring a lunch/dinner/both.
    • Bring a seat cushion.
    • Party affiliation is based on the lists sent from the political parties. If you are not included on a letter, you will be listed as unaffiliated. 
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

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